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NPI Code Detail

MEDICARE: MR. NEAL BRUNKHORST CRNA

MEDICARE: MR. NEAL BRUNKHORST CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist95001831CA
2367500000XCertified Registered Nurse Anesthetist124387MO

General Provider Information

NPI Number : 1740391440
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. NEAL BRUNKHORST CRNA
Provider Business Mailing Address
First Line : 400 S WOODS MILL RD STE 140
Second Line :
City : CHESTERFIELD
State : MO
Zip : 63017-3427
Country : US
Telephone Number : 314-680-5370
Fax Number :
Provider Business Practice Location Address
First Line : 400 S WOODS MILL RD STE 140
Second Line :
City : CHESTERFIELD
State : MO
Zip : 63017-3427
Country : US
Telephone Number : 314-485-1101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 02/26/2025

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Directions to “ MR. NEAL BRUNKHORST CRNA” Practice Location

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